( 8 7 ) 
8. All coolies must rinse their hands in a solution of i in 
i,ooo corrosive before meals. 
9. Change the bathing places iPpossible. 
10. Limewash or corrosive wash all benches in the kuchies. 
11. In the case of small-pox universal vaccination. 
12. In the case of plague, plague vaccination and disinfection as 
above. 
Dengue. 
This disease is an exceedingly sudden,, and extremely infectious 
fever, it is marked by severe pain in the bones and joints, a rash 
usually appears, but in this country is rather fickle in its appearance, 
in the early stage of the fever it occurs as a simple redness of the 
general body surface, which is hard to demonstrate on dark skins. 
The pain in the joints and bones is frequently very serious, and the 
disease has hence acquired the name of “‘break-bone” fever. It almost 
invariably occurs in epidemic form, and rapidly spreads, it may be 
“ seen coming ” and advances from the neighbouring towns rapidly, 
when it has once declared itself. 
After the primary fever a short interval of calm or freedom from 
fever occurs, and patients may even feel fit to go to work, but the 
secondary fever then breaks out, and a rash the true rash of dengue 
shows up, this commences on the palms and! backs of the hands, is 
best seen on the back of the body to which it quickly spreads. It 
consists of slightly elevated, circular, reddish brown, spots, about 
half an inch in diameter, which eventually “coalesce to form plates 
of red. 
Peeling occurs, and may last for some t'ime (2 to 3 weeks). 
Isolation of the first cases is advisable,* but* the disease spreads so 
rapidly that it were advisable not to expect too much of isolation as 
a preventive measure in this disease. 
Influenza. 
As the vast majority of us have had personal experience of this 
disease, I shall merely draw attention to the leading symptoms once 
more to remind those who have suffered of their miserable time, and 
to claim kindness, or at least consideration, for coolies who become 
affected by it ; sneezing, cold in the head with fever, pain in the back, 
rheumatic pains all over, general miserableness. Quinine and salicylate 
of soda are useful drugs in the disease, but it must notbe trifled with 
nor neglected. 
Measles. 
The rash comes out on the fourth day of fever, it is well defined, 
and the “running at the eyes” usually helps to diagnosis, exposure 
must be avoided, as pneumonia is a rather frequent complication. 
